Qualitative Descriptive Exploratory Study Research Articles

Lived experiences of palliative care physicians on the impacts of language and cultural discordance on end-of-life care across Ontario, Canada: a qualitative study using the intersectionality-based policy framework

BackgroundLanguage and cultural discordance refer to when a physician and patient do not share the same language or culture. This can create barriers to providing high-quality care at the end-of-life (EoL). This study explores the intersections of language, culture, geography, and care model in EoL care from the perspectives of palliative care physicians.MethodsIn this exploratory-descriptive qualitative study, semi-structured interviews (1-h) were conducted virtually between July and November 2023. We interviewed 16 family physicians with experience providing linguistic and/or culturally discordant palliative/EoL care in various urban, suburban, and rural regions of Ontario, who practiced at community and hospital outpatient clinics, home-based care, or long-term care homes. We used reflexive thematic analysis to identify themes across the interviews guided by the intersectionality theoretical framework.ResultsWe identified three themes 1) Visible barriers to care access due to the inability to communicate accurate information and insufficient time spent during appointments with patients; 2) Invisible barriers to care access, shaped by the Eurocentric approach to palliative care and physicians’ lack of awareness on cultural discordance; 3) Workplace supports that currently exist and interventions that physicians would like to see. Community physicians following fee-for-service models were less likely to have access to professional interpreter services. Physicians in long-term care emphasized resource limitations to providing culturally-appropriate care environments.ConclusionCultural discordance required awareness of personal biases, while language discordance hindered basic communication. These findings will be useful in informing clinical practice guidelines and mobilizing policy-level change to improve palliative/EoL care for patients from linguistic and cultural minority groups.

Are we preparing healthy & responsible adolescents? Exploratory qualitative study to understand the health and social issues of adolescent living in Karachi, Pakistan.

This study aimed to understand the lives of adolescents living in squatter settlements of Karachi, Pakistan regarding their assigned roles and responsibilities, health and social issues, their decision-making process, and mechanism and channels of information. An exploratory descriptive qualitative study design was employed. Purposive sampling techniques were used to carry out Focus Group Discussions (FGDs) with adolescents (n = 10, Participants = 190), adolescents' parents (n = 10, Participants = 180), and In-Depth Interviews of with key adolescent stakeholders (n = 20). Adolescent stakeholder mapping was conducted for enrolling participants. The data were analysed thematically using deductive and inductive approaches. Based on gender norms parents assign specific roles and responsibilities to adolescent girls and boys. Due to societal norms, communication gap exists between adolescents and their parents. The most popular information channels are social media platforms and friends. Adolescents reported being subjected to a variety of physical, sexual, mental, social, and environmental pressures. Lack of guidance from parents, inadequate knowledge and skills to deal with physical, sexual, mental, social and environmental hazards, and misuse of social media lead to risky decisions, injuries, and social instability. This study underlines the urgent need for targeted interventions for addressing gender issues and improving adolescents' decision-making and life skills. We recommend Behavior Change Communication interventions to dismantle gender stereotypes and support a balanced domestic environment for children's education and well-being, awareness raising among parents, teachers, and healthcare providers about adolescent risks emphasizing their role in youth guidance, and advocacy for youth-led forums to co-create educational content engaging parents, educators, and health professionals focusing on life skills. These strategies would turn demographic transitions into productive dividends.

Exploring cultural competence barriers in the primary care sexual and reproductive health centres in Catalonia, Spain: perspectives from immigrant women and healthcare providers

BackgroundImmigrant populations, especially women, continue facing challenges in accessing quality healthcare, particularly sexual and reproductive health services (SRH). Poor cultural competent health systems contribute to communication challenges between immigrant women and healthcare providers perpetuating health disparities. This exploratory study describes these communication barriers from the perspective of Moroccan and Pakistani immigrant women and healthcare providers within the Catalan health system and its implications to ensure an equitable provision of SRH services.MethodsAn exploratory-descriptive qualitative study was conducted in various municipalities of Barcelona with high concentration of immigrants. Eight focus groups (N = 51) and semi-structured interviews (N = 22) with Moroccan and Pakistani immigrant women were combined with key informant interviews (N = 13) with healthcare professionals. Thematic analysis and data triangulation were performed primarily using an inductive approach.ResultsLanguage barriers and cultural differences in health needs, expectations, care-seeking behaviours and understanding of quality healthcare provision hindered the ability of immigrant women and providers to interact effectively. Limited availability of intercultural mediators and inadequate cultural competence training opportunities for health staff were also identified. Findings suggest a lack of minority representation in the Catalan health workforce and leadership roles.ConclusionThis study reinforces the evidence of persistent inequities in accessing healthcare among immigrant populations by focusing on the cultural competence barriers of the Catalan health system in the provision and access to SRH services. The regularization of adequately trained intercultural mediators, quality training in cultural competence for health staff and a commitment to increase workforce diversity would contribute to improve intercultural communication between immigrant patients and providers. An urgent call to action in this direction is needed to ensure an equitable access to SRH services among immigrant women.

Peer-to-Peer Human Milk Sharing Through Social Media Groups: The Experiences of Women Donors and Recipients in Hong Kong.

To explore the lived experience of donors and recipients involved in peer-to-peer human milk donation. An exploratory descriptive qualitative study. Semi-structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis. Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route. The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing. The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks. Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon. The Standards for Reporting Qualitative Research (SRQR). No patient or public contribution.

Circumstances leading to home childbirths among women living in Winterveldt, Tshwane Municipality of South Africa.

Childbirth complications, which may include maternal and perinatal mortality are common among women giving birth at home compared to those giving birth at health care facilities. Increasing access to childbirth in health care facilities improves the maternal and perinatal health outcomes for both the mother and child. There are however reported cases of home childbirth and decreasing numbers of health care facilities' births in developing countries. The researchers identified an increase in number of babies born before arrival in several health care facilities and therefore explored this phenomenon in order to understand circumstances leading to this practice. The findings of the study have a potential to inform interventions and strategies to strengthen community health education and engagement on maternal and child health issues. Information gathered through this study will also be important in informing decision making on prioritization of key interventions to incorporate Traditional Birth Attendants (TBAs) services in reproductive health care. An exploratory descriptive qualitative study was used to conduct in-depth interviews amongst women of childbearing age living in a semi urban area of the Tshwane municipality in South Africa. The sample of this study was made of 21 purposively selected women who had experienced home childbirth. Thematic content analysis was used for data analysis. Many women made a choice to give birth at home due to religious and cultural beliefs. However, some women wished to give birth in a health care facility but due to unintentional factors such as lack of transport, failure to identify labour pains, and fast labour; they ended up giving birth at home. Some of the women indicated harsh treatment in health care facilities compared to the pleasant birthing experience at home as reasons for opting for home childbirth.

Why do women with early breast cancer in Northern Sri Lanka undergo mastectomy? Decision-making and ways forward

BackgroundDespite robust evidence confirming equivalent survival rates and better cosmetic outcomes with breast-conserving surgery (BCS) and radiotherapy compared to mastectomy, the rates of mastectomy among women with early breast cancer have not declined significantly in Sri Lanka. This study explores views on the surgical treatment of breast cancer among Northern Sri Lankan women who were eligible for BCS but underwent mastectomy.MethodsAn exploratory descriptive qualitative study was carried out among 15 women who underwent mastectomy for early breast cancer. Patients who were referred to the Tellippalai Trail Cancer Hospital for adjuvant therapy after mastectomy and matched the study criteria were recruited. Data were collected through in-depth semi-structured interviews, which were transcribed in Tamil, translated into English, coded using QDA Miner Lite software, and analysed thematically.ResultsNine out of 15 participants were either not aware of breast-conserving surgery (BCS) as a treatment option or their eligibility for BCS at the time of mastectomy. According to participant narratives, the treating team had recommended mastectomy to most participants. While many opted for mastectomy believing that it was associated with lower rates of recurrence and spread compared to BCS, these beliefs were frequently reinforced by the treating team. The pros and cons of the two approaches had not been discussed before surgery with most participants. In the absence of information, family and friends weighed in on the decision to opt for mastectomy, ultimately resulting in feelings of loss and regret in most instances.ConclusionMost participants were not aware that they were eligible for BCS. These information gaps need to be urgently addressed for women to make informed decisions about their health.

Caregivers’ experiences on preterm infants’ management in a tertiary care facility in Ghana: a qualitative exploratory study

BackgroundPreterm birth is a process that fundamentally alters parental or caregiver roles, particularly in the early weeks of childbirth. Caregiver experiences can be distressing due to struggles with an unfamiliar and potentially threatening environment of the Neonatal Intensive Care Unit (NICU). These experiences can affect the development of parenting or caregiving roles to a greater extent. Supporting caregivers of preterm infants through education and information sharing can significantly improve neonatal outcomes. This study sought to explore the experiences of caregivers with hospitalized preterm infants regarding the education and information they received from healthcare workers on the care of preterm infants.MethodAn exploratory descriptive qualitative study that explored caregivers’ experiences with the management of preterm infants hospitalized at the Level III Neonatal Intensive Care Unit (NICU) of a tertiary level facility with an annual delivery of almost 7500 and a bed capacity of 26. The study utilized a deductive approach and a purposive sampling technique to recruit 16 caregivers who participated in an in-depth interview using a piloted semi-structured interview guide. The interviews were audio-recorded, transcribed, and analyzed using thematic analysis.FindingsThe study identified three major themes, which were (1) preterm infant feeding and keeping infants warm, (2) routine procedures and activities at the NICU, and (3) preparation towards homecare after discharge. Seven (7) sub-themes were generated. Caregivers were satisfied with the education and information they received on infant feeding and keeping the infant ward. They also had adequate education that prepared them for home care of the preterm infant. Caregivers did not receive timely information and education on the health status of their infants and the care processes of the NICU. They felt they were left out as they were not involved in decision-making. Regarding the care of the preterm infant. The inadequate flow of information and use of medical terminologies were a great source of worry and frustration for participants. The study showed that although the NICU staff were willing to offer health education to caregivers, information giving and education were not structured and hence did not address all the needs of the caregivers.ConclusionHealthcare providers caring for preterm infants include caregiver education in their routine NICU activities and procedures. These processes start from the period of admission till discharge. Their education sessions primarily focus on breastfeeding, keeping the infant warm and adequate preparation of caregivers for preterm infant home care. This notwithstanding there are gaps in caregiver education and information on routine procedures in the NICU as well as information on the health needs of the infant. Participants are not fully involved in the decision-making processes and the use of medical terminologies compound caregivers’ frustrations and anxieties. It is important to develop structured educational programs tailored to address the information needs faced by caregivers to ensure optimal health outcomes for their preterm infants.

Exploring the role of the Recovery College model as a transformative tool for recovery-oriented practice: perceived benefits and perspectives from health practitioners in Quebec, Canada.

Mental health practitioners (MHPs), including occupational therapists (OTs), need support to adopt a truly recovery-oriented practice. Like other practitioners, if OTs often embrace the principles of recovery as a philosophical foundation for their practice, these principles may not always reflect in their attitudes, behaviors or in their interventions. While further research is needed to demonstrate the positive effects of recovery-oriented training programs on MHPs' attitudes and practice, there is a need to explore novel training programs. The Recovery College (RC) model is one of the interventions that are designed to facilitate these changes in practice, through co-production and co-delivery of recovery-focused courses curriculum. Although the perceived benefits and outcomes of RC courses are widely documented, very few studies focus specifically on what MHPs gain from them or on their global experience. The aim of this article is to describe the experience of MHPs learners in RC courses and the perceived benefits on their practice. An exploratory descriptive qualitative study was conducted. Data were collected through semi-structured interviews and analyzed using Miles and Huberman's stepwise qualitative analysis method. Participants were 13 MHPs working in community organizations or healthcare institutions and who participated as learners in a RC, in the province of Quebec, Canada. Ten themes emerged from the qualitative analysis. Participants expressed their perspectives on the format of the courses, their initial expectations and their recommendations. They also identified the types of knowledge they shared during the courses. Participants reported changes in their practice, raised awareness on their clinical and personal issues, improved well-being and recovery. Group composition, interactions within the group, complementarity of the different types of knowledge, and pedagogical design and learning activities were identified as key ingredients of RC. This study highlighted RCs' role in enriching MHPs clinically and personally. RC curriculum and courses drive changes in practice and attitudes towards service users. RCs may assist MHPs reflect on practice and improve their clinical reasoning. This study advances understanding of a promising, accessible training program for adopting a recovery-oriented practice amid a paradigm shift among MHPs and OTs.

Perceptions of primigravida and their husbands regarding the need for maternal-fetal attachment stimulation

Prenatal class programs for primigravidas are important to improve fetal care behavior and reduce infant mortality. In prenatal classes, there is no maternal-fetal attachment stimulation education program which is important for improving maternal-fetal attachment and fetal well-being. The perceptions of pregnant women and their husbands regarding knowledge and experience of pregnancy as well as maternal-fetal attachment (MFA) stimulation are important for assessing the need for MFA educational materials. The research aimed to examine the perceptions of primigravidas and their husbands regarding pregnancy and MFA stimulation. Exploratory descriptive qualitative study method. Data were collected using in-depth interviews with 10 primigravidas and their husbands at the Community Health Center in Bantul, Yogyakarta, Indonesia, using an interview guide. Data analysis by condensing data, presenting data, and drawing conclusions, verbatim results of interviews are presented in coding, found categories, and themes. Four themes were produced: knowledge of pregnancy and fetal growth and development; concept of maternal-fetal attachment skills; management of pregnancy emotional management; and husband's support. The conclusion of this theme's findings underlies the development of maternal-fetal attachment educational materials in prenatal classes to prepare mothers for their role, and improve MFA and maternal-fetal health.

Witzenberg Women's experience of health care after a miscarriage: A descriptive qualitative study.

Although some evidence is available from low- and middle-income countries, no South African data are available on how women experience healthcare during treatment for an incomplete miscarriage. This study sets out to explore and describe the experiences of healthcare among women who suffered an incomplete spontaneous miscarriage in the Witzenberg subdistrict, a rural area in the Western Cape province of South Africa. Witzenberg subdistrict, Western Cape province, South Africa. This study used a descriptive exploratory qualitative study design. In-person interviews were held with women who experienced a miscarriage. Interviews followed a semi-structured format by a single interviewer to explore the various aspects involving experiences of healthcare. Eight interviews were conducted and analysed. The five themes that arose from transcribed data were: (1) a need for safety, (2) pain management, (3) moderating behaviours and attitudes, (4) disorienting healthcare systems and (5) abandonment. Several factors contributed to the loss of physical and emotional safety in the emergency centre environment. Timeous emotional and pharmacological pain management were found to be a gap while patients awaited care. Clear communication and staff attitude were found to be integral to the patient's experience and could avoid the perception of abandonment. There is a universal need for basic respectful, supportive and safe care in patients who attend an emergency centre for early pregnancy complications in rural South African. Specific focus should be given to clear communication and appropriate emotional support during and after the miscarriage.Contribution:This study can be used as a guide to improve services by ensuring respectful, transparent, informed, and appropriate continuity of care.

Nurses' Beliefs About Pain Assessment in Dementia: A Qualitative Study Informed by the Theory of Planned Behaviour.

To explore registered nurses' beliefs regarding pain assessment in people living with dementia. A descriptive exploratory qualitative study informed by the Theory of Planned Behaviour. Online semi-structured in-depth interviews were conducted from January to April 2023 with a purposive sample of 15 registered nurses caring for people with dementia. Following transcription, data were analysed using direct content analysis. Registered nurses believe pain assessment improves the well-being of people with dementia and informs and evaluates practice. However, there is a possibility of misdiagnosing pain as agitation or behavioural problems, leading to inaccurate pain management. Interpersonal factors, such as registered nurses' knowledge and experience, beliefs and motivation to improve care provision, were the primary facilitators of pain assessment. Physical and behavioural dimensions of the pain of the dementia syndrome were the most reported barriers to pain assessment. Registered nurses reported that multidisciplinary team members expect them to do pain assessments. Most did not experience disapproval when performing pain assessments. Registered nurses hold beliefs about pain assessment benefits, consequences, enablers, barriers, approvals and disapprovals regarding dementia. The findings could inform interventions to enhance pain assessment practices. Policymakers should provide education opportunities for registered nurses to improve their knowledge, skills and beliefs about pain assessment in dementia. Future research should develop and implement multidisciplinary, multifaceted pain assessment protocols to enhance the accuracy of pain assessment practices. Pain is underassessed in dementia, and this could stem from registered nurses' beliefs about pain assessment in dementia. The findings could inform interventions to enhance pain assessment beliefs and practices. This study adhered to the COREQ criteria. Registered nurses caring for people living with dementia participated as interview respondents.

Perception and experience on SAM among 6-59 months children in Ari zone, S/Ethiopia

Objectives: The objective of this study was to explore caregivers’ perceptions of and experiences with SAM among children aged 6–59 months in the Ari Zone, South Ethiopia, 2023. Material and Methods: From June to August 2023, an exploratory-descriptive qualitative study was carried out in the Ari Zone of South Ethiopia. In-depth interviews and focused group discussions were utilized in the study to describe the perspectives and experiences of the caregivers. The application of credibility, transferability, dependability, conformability, and authenticity preserved the scientific rigor and reliability. NVivo version 12 Pro software was utilized to conduct the inductive thematic analyses. Results: The ways in which caregivers manage SAM and its shared challenges were described using four predominant themes, namely, community-related challenges, hygiene and sanitation, food insecurity, and health system-related challenges. Conclusion: As a result, malnutrition is not well understood by families of children, and traditional practices, especially kella, have predominantly been performed in study areas with paradoxical diagnoses and identical symptoms of SAM. Economic incapability influences tackling SAM in children. The health system has limitations in terms of supplies, service delivery, and professional ethics. These situations need to be improved by working on community awareness and empowerment, strengthening the system and further investigating traditional practices.

“Why wouldn't we want to do this?” The challenge for oncology hospital nurses to engage in serious illness conversation and advance care planning

BackgroundThe viability of advance care planning (ACP) in cultures where discussing future desires is taboo is unclear, it is essential to examine the challenges faced by Chinese nurses lacking legal protection for ACP. AimsTo comprehend Chinese oncology nurses' perceptions of serious illness conversation and ACP, and identify barriers to engagement. MethodsA qualitative descriptive exploratory study involving semi-structured interviews with 13 experienced oncology nurses, analyzed using thematic analysis and critical incident technique, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. FindingsFour themes emerged: Inadequate Competence Causes Patient Harm, Cultural Influences to Patient Autonomy, Psychological Tolerance Neglects Best Interests, and Systemic and Legal Uncertainties Impact Patient Rights. ConclusionPolicy changes supporting nurses in ACP implementation, a 'whole-system strategic approach' involving legislative changes, organizational support, and public awareness are crucial for optimizing ACP and meeting diverse patient needs.

Nurturing ethical insight: exploring nursing students’ journey to ethical competence

BackgroundEthical competence is a key competence in nursing and the development of the competence is a central part in nursing education. During clinical studies, nursing students face ethical problems that require them to apply and develop their ethical knowledge and skills. Little is known about how ethical competence evolves during students’ initial clinical placements. This study explored the development of ethical competence in first-year nursing students during their first clinical placements in nursing homes.MethodsThis exploratory-descriptive qualitative study used focus group interviews to collect data and a phenomenological hermeneutical method for analysis. Twenty-eight first-year nursing students participated in six focus groups. The data were collected between March and April 2024 at Oslo Metropolitan University in Norway.ResultsThe naïve reading of the data involved an awareness of the students applying their prior knowledge, modifying their prior knowledge and developing skills that allowed them to manoeuvre ethical practices that, in some cases, appeared excellent and, in other cases, grim. The structural analysis identified three themes: (i) ethical competence forges in practice, (ii) ethical competence evolves at the intersection of knowledge and skills and (iii) ethical competence unfolds through meaningful discussions. A comprehensive understanding of the data was formulated as ‘Being on a journey towards ethical competence’. This presents a metaphor illustrating that nursing students embark on a journey towards ethical competence; from their point of departure, their clinical experiences forge the essential waypoints along their path, knowledge and skills fuelling their navigation in rugged terrain towards their destination.ConclusionsNursing students’ ethical competence evolved in intricate ways during their initial clinical period. Being informed bystanders or participants in the care of nursing home residents in situations of ethical tension may be a unique position enabling students to evaluate care options differently from those immersed in the ward culture. The findings indicate that organised professional development in nursing homes needs to focus on more reflexively driven ways of supervising students in their first clinical study period. Educational institutions need to continue and further develop reflection-based learning activities and meeting points with students and their peers during their clinical placement periods.

Perspectives of providing magnesium sulfate to patients with preeclampsia and eclampsia: A qualitative study amongst nurse-midwives in Dar es Salaam, Tanzania.

Preeclampsia and eclampsia are among the leading direct causes of maternal death and morbidity worldwide. Up to 34% of maternal deaths in Tanzania are due to preeclampsia/ eclampsia. Magnesium sulfate is recommended for preventing and treating convulsions in women with Preeclampsia or eclampsia. However, evidence suggests limited knowledge of its dosage and proper toxicity assessment after administration among health care providers. This study explored nurse-midwives' perspectives on providing MgSO4 to patients with preeclampsia or eclampsia in Tanzania. A descriptive exploratory qualitative study using in-depth interviews was conducted to understand nurse-midwives' perspectives on providing magnesium sulfate to patients with PE/E. Nineteen nurse-midwives were interviewed from three hospitals in the Dar es Salaam region. We used a semi-structured interview guide in Kiswahili language to collect data. All interviews were digitally recorded and transcribed verbatim. We analyzed data using inductive content analysis. This study revealed that nurse-midwives provide magnesium sulfate to save the lives of women and their unborn children. Nurse-midwives reasoned that confidence in their skill enhances provision of magnesium sulfate. However, they were concerned about its effect on the progress of labour. Ineffective use of magnesium sulfate emerged from inadequate training, an unsupportive work environment, and underutilization of the existing guidelines. Nurse-midwives have clear drive to provide magnesium sulfate to women with preeclampsia or eclampsia. However, inadequate training, underutilization of guidelines and unsupportive work environment lead to ineffective use of magnesium sulfate. Targeted practical training should be emphasized for nurse-midwives mastery of clinical competencies.

Exploring strategies promoting interprofessional collaborative practice in spinal cord injury rehabilitation at a private South African hospital group

Background. Implementing an interprofessional collaborative practice (IPCP) in hospitals improves health outcomes, enhances patient safety and reduces length of stay by optimising resource utilisation. Although this approach was desired at a private hospital group in South Africa (SA), the specific strategies for clinical guidelines and capacity management pertaining to spinal cord injury (SCI) patients and the implementation of IPCP were unknown. Objective. To explore strategies for implementing clinical guidelines and capacity management for SCI rehabilitation to promote IPCP in a private hospital group in SA. Method. This exploratory descriptive qualitative study included participants who were selected through purposive sampling. The participants comprised 11 staff from various disciplines and management of the private hospital group, one local and one international expert in IPCP. Three online focus groups (n=13) were conducted, involving three to five participants. The transcriptions were analysed thematically using Braun and Clarke’s framework. Results. Interprofessional communication and tools as well as capacity development were three emergent themes from the data. Strategies pertaining to communication methods, digitisation, visual displays, patient care information, educational information and education of healthcare workers were suggested to promote IPCP. Conclusion. These findings from the emergent themes could assist in implementing and integrating an IPCP approach into the rehabilitation service. Further research assessing the efficacy of implementing the IPCP strategies and digital platform would be beneficial.

Breastfeeding mothers' awareness and experience of using the breastfeeding memory aide CHINS: An exploratory descriptive qualitative study

AbstractBackgroundBreastfeeding has immediate and long‐term benefits for both mother and child, but many mothers feel unprepared for the challenges of early breastfeeding. The first letter mnemonic, close, head free, nose to nipllie, in‐line, sustainable (CHINS) was developed as a tool to help practitioners remember retain and recall the principles of positioning for effective breastfeeding and a UK‐wide evaluation shows it is used widely within the UK breastfeeding workforce. This study sought to understand the extent to which breastfeeding mothers were aware of CHINS and their experience of using it to support their breastfeeding.MethodsAn exploratory qualitative research design was used to describe and interpret the findings of individual interviews with 11 breastfeeding mothers from across the United Kingdom who were recruited via a digital flier shared via social media and breastfeeding networks. The interviews were analysed thematically.ResultsAwareness and perception of CHINS, Timing of introduction to CHINS, and Sharing CHINS were the key themes to emerge, with an overarching core theme—The Right Advice at the Right Time. All the participants in the study were aware of CHINS and found it particularly helpful during the early stages of breastfeeding. Some participants reported that others, including fathers and peers, were aware of CHINS and had used it to support breastfeeding mothers. The participants felt support for breastfeeding was variable and that it was important to ensure that the right advice was given at the right time.ConclusionThis study included a small number of breastfeeding mothers from across the United Kingdom and whilst there were high levels of awareness and perceived value of CHINS, a larger study would be warranted to explore the value of CHINS in more depth as well as to understand the role of CHINS in the wider education of peers and significant others, including fathers.

Healthcare workers' views on type 2 diabetes mellitus management at selected clinics in Mthatha.

Diabetes is a non-communicable disease of global public health importance. Healthcare workers play a vital role in the management of this disease. This study aimed to explore healthcare workers' views on managing patients with type 2 diabetes at primary health care facilities. The study was conducted at two primary health care facilities in Mthatha, South Africa. This exploratory descriptive qualitative study included 28 primary health care workers. Data were collected through individual interviews and focus group discussions and analysed using a thematic analysis approach. Study participants' views of poor control of type 2 diabetes mellitus were categorised under patient- and healthcare system-related factors. The patient-related factors included poor adherence to an ideal diabetic diet, poor medication adherence, a lack of personal glucometers, and dearth of support systems. The healthcare system-related factors identified were inadequate patient education, long waiting times at the health facilities, high patient volumes, limited resources, and delayed service provision. Proposed solutions to address poor control of diabetes included improving patient health education, providing diabetic patients with glucometers, multi-stakeholder management of diabetes, allocating designated areas for patients with chronic illnesses, improved resource allocation, and regular staff training. Study participants perceived an improved level of control of diabetes among patients managed at the Community Health Centres. When designing interventions for the management of diabetes, both patient and healthcare system-related factors and the proposed solutions should be considered.Contribution:This study's findings could promote better management of diabetes at the primary health care level.

A Qualitative Exploration of Stroke Survivors' Experiences of Using a Stroke Helpline.

StrokeLine is a stroke-specific helpline used by stroke survivors and their families in Australia to access professional support. There has been little research exploring stroke survivors' experiences of using helplines and their perceived impact on their stroke recovery. The aim of this study is to explore the reasons prompting stroke survivors to call StrokeLine and their experiences and to describe the perceived impact of calling StrokeLine on their recovery. An exploratory descriptive qualitative study was undertaken using thematic analysis of data collected through semi-structured interviews of stroke survivors between December 2020 and May 2022. Participants were recruited using purposive sampling. Interviews were conducted via audio-recorded Zoom conference calling and transcribed verbatim for thematic analysis. A total of eight callers (four men and womenwomen) participated, with the time since stroke ranging from 3.5 months to 5 years. Four major themes were identified, including 17 sub-themes. Key themes included (1) factors prompting use of StrokeLine; (2) experience of using StrokeLine; (3) perceived impact of using StrokeLine; and (4) conceptualising StrokeLine service provision. Participants perceived their experience of contacting StrokeLine as having a positive impact on their stroke recovery, leaving them feeling empowered and motivated to self-manage their condition. Stroke survivors with lived experience influenced the conceptualisation of this study through conversations with consumers and the Stroke Foundation. Eight stroke survivors were involved as participants in the research study.

Can you be unique by wearing fast fashion? Exploring South African contemporary female consumers’ creative behaviour towards fast fashion uniqueness

Contemporary female consumers manage their appearance through current fashion trends and styles. The desire to be unique drives consumers to develop appearances that are perceived to differentiate them from others. In a world where fast fashion delivers multiple copies of one fashion item, it is difficult to imagine if fast fashion could deliver a unique appearance. Little research has considered the possibility of achieving fast fashion uniqueness. The behaviour of South African female consumers and their desire for fast fashion uniqueness as proposed in the theory of the need for uniqueness has also not been researched. The purpose of this study was to determine the meaning of fast fashion uniqueness and the behaviour related to the dimensions of uniqueness. An exploratory descriptive qualitative study was used to determine the fast fashion unique experiences of female fashion shoppers in South Africa. Thematic analysis of electronic individual interviews revealed the meaning of uniqueness manifested through mechanisms of self-expression and design creativity. Contribution to uniqueness theory is expressed through a socially acceptable appearance typified by creative choice counter-conformity behaviour. Unpopular choice counter-conformity behaviour was expressed through precautionary and guarding behaviour. Avoidance of similarity behaviour resulted in similarity acceptance behaviour characterized by helplessness and acceptance of fast fashion duplication, due to the inability to avoid similarity experienced during fast-fashion retail purchases. Coping strategies and avoidance behaviour tactics were applied to avoid fashion similarities. Fashion creativity serves as the mechanism through which contemporary fast fashion consumers achieve fast fashion appearance uniqueness. Fast fashion retailers in South Africa may need to improvise fashion offerings and give consumers alternative appearances to accommodate the creative uniqueness that female consumers are compelled to apply to achieve fast fashion uniqueness.